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This report describes an extremely rare combination of mediastinal germcell tumor and visceral hemangiomatosis in a 17-year-old boy who initially presented with chest pain and dyspnea. He was treated with chemotherapy consisting of cisplatin, cyclophosphamide, bleomycin, vinblastine, and dactinomycin followed by surgery. Multiple low-density nodules developed in the spleen three weeks later, suggesting metastases from the primary tumor, but the resected specimen showed cavernousdoi:10.2169/internalmedicine.37.1042 fatcat:ansh6thfzjd5xl4vknfm4syxqu